WASHINGTON  More than 18,000 adults in the USA die
each year because they are uninsured and can't get proper health care, researchers
report in a landmark study released Tuesday.

The 193-page report, "Care Without Coverage: Too Little,
Too Late," examines the plight of 30 million  one in seven  working-age
Americans whose employers don't provide insurance and who don't qualify for
government medical care.

About 10 million children lack insurance; elderly Americans
are covered by Medicare.

It is the second in a planned series of six reports by
the Institute of Medicine (IOM) examining the impact of the nation's fragmented
health system. The IOM is a non-profit organization of experts that advises
Congress on health issues.

Overall, the researchers say, 18,314 people die in the
USA each year because they lack preventive services, a timely diagnosis or appropriate
care.

The estimated death toll includes about 1,400 people with
high blood pressure, 400 to 600 with breast cancer and 1,500 diagnosed with
HIV.

"Our purpose is simply to deliver the facts, and the facts
are unequivocal," says Reed Tuckson, an author of the report and vice president
for consumer health at UnitedHealth Group in Minnetonka, Minn.

Among the study's findings is a comparison of the uninsured
with the insured:

Uninsured people with colon or breast cancer face a 50% higher risk of death.

Uninsured trauma victims are less likely to be admitted to the hospital,
receive the full range of needed services, and are 37% more likely to die
of their injuries.

About 25% of adult diabetics without insurance for a year or more went without
a checkup for two years. That boosts their risk of death, blindness and amputations
resulting from poor circulation.

Being uninsured also magnifies the risk of death and disability
for chronically sick and mentally ill patients, poor people and minorities,
who disproportionately lack access to medical care, the landmark study states.

"The report documents the immense consequence of having
40 million uninsured people out there," says Ray Werntz, a consumer health expert
with the Employee Benefit Research Institute. "We need to elevate the problem
in the national conscience."

Calculating the cost in human suffering, he says, "is one
way to get there."